Objective To evaluate the necessity and practicability of optimizing the management of type 2 diabetes mellitus in community after acquiring the peer education and the music therapy to their physical and mental issues and sleep problems. Methods Totally 179 type 2 diabetes mellitus patients who were followed up in Ruijin 2nd community health service center, the random numbers table used to randomize the patients into 2 groups:control group ( 97 cases) and experiment group ( 96 cases), the conventional treatment was used in control group. Besides the conventional treatment measures, the peer support was used by patients in the experiment group. In the second step, 45 patients were met the inclusion and the exclusion criteria, the random numbers table used to randomize the patients into 2 groups:the multiple intervention group (22 cases) and the conventional treatment group (23 cases), the multiple intervention included the music therapy, the peer support and the sleep health education, the conventional treatment included the conventional treatment and the sleep health education. The t test was used to compare the patient's HbA1c and other quantitative data in two groups of patients after the intervention. Results In the first stage of research, compared with the control group patients, the patients 'HbA1c in intervention group was significantly improvement after 6 months(7.26%±1.37%vs.7.53%±1.63%,t=2.148, P<0.05),besides, the intervention group individuals achieved significant improvement in diabetic self-management behaviors and self-efficacy after 6 months, and the improvement in self-efficacy of peer support group was significant different compared with routinely educated patients(104.09±16.40 vs.110.96± 13.86,t=2.120,P<0.05), and the PHQ-9(5.95 ± 4.02 vs.2.55 ± 1.67,t=2.630,P<0.05)between the two group had significant difference, while no improvement was found in PSQI, BMI, and WHR between intervention group and control group. Conclusions Peer support could improve the blood glucose metabolism in patients with type 2 diabetes. With the effect of yoga music and physical exercises, peer support can improve the quality of sleep and decrease depression in T2DM patients, who also have sleep disorders and mild depression.

· AIM: To investigate whether heat shock protein 27 (HSP27) is induced in retinal ganglion cells (RGCs) in experimental rat glaucoma and whether the induction of HSP27 by intraocular pressure (IOP) elevation can increase serum autoantibody to HSP27 in the model.IOP elevation、Sham and normal groups by SPSS12.0. IOP was raised by electrocoagulating at least 3 episcleral veins and limbal veins on the right eye of each rat in IOP elevation group and its contralateral eye was used as controls. Immunohistochemical staining for HSP27 was performed in RGCs and retinal nerve fiber layer (RNFL) and serum immunoreactivity against HSP27 was detected by means of enzyme-linked immunosorbent assay (ELISA) in three groups.RNFL of the eyes with IOP elevation, while it was expressed weakly in untreated control eyes. Compared with sham and normal groups, serum autoantibody to HSP27 was slightly high at 1wk (P ＞0.05) and significantly increased at 2, 3, 4 and 8wk (P＜0.05) in IOP elevation group.enhanced expression of the endogenous HSP27 might play an important role in glaucomatous optic neuropathy.

AIM: To study the experimental method of inducing the chronic intraocular hypertension in rat eyes.METHODS: Twenty Wistar rats were randomly divided into ocular hypertension and Sham control groups. Intraocular pressure (IOP) was raised by electrocoagulating at least 3 episcleral and limbal veins on the right eye of each rat in ocular hypertension group and its contralateral eye was used as control. At 1, 2, 3, 4 and 8wk after the electrocoagulation of the veins, IOP were measured. RESULTS: The treatment of electrocoagulation caused a significant IOP increase of the right eyes over the baseline, over the contralateral eyes, and over the sham control eyes (repeated measures ANOVA, P＜0.001). At 1wk,IOP was (30.12± 5.L8 ) mmHg (1kPa=7.5mmHg), and maintained the high IOP up to 8wk.CONCLUSION: The chronic intraocular hypertension model could be successfully created by electrocoagulating three or more episcleral and limbal veins.

Objective To evaluate the clinical effect of retrievable esophageal covered metal internal stent in treating patients with achalasia.Methods Under DSA guidance,peroral"Z-type"double horn covered metal internal stent implantation was performed in 16 patients with achalasia.Esophagography was carried out about 28 days after the procedure and the stent was retrieved.Results Of 16 cases,the stent fell off into the stomach two weeks after the operation in one.And the stent was successfully replaced after it was taken out.The placed stent was successfully retrieved in all cases 28 days after the treatment.No serious complications occurred.All the patients were followed up for 3 months to 3 years.During the follow-up period restenosis of the esophagus developed in two cases(at one and 1.5 years respectively),and the restenosis degree was relived after balloon dilation.Clinically,no esophageal symptoms,such as dysphagia,occurred in all patients.Conclusion As a simple and safe technique,the retrievable esophageal covered metal internal stent implantation is very effective with fewer complications for the treatment of achalasia.Moreover,the technique carries lower restenosis occurrence.

In this study ,a wild type Salmonella typhimurium (S .typhimurium) strain was isolated and identified in Hong Kong (S129) ,then the asdA gene was knocked out and replaced with kanamycin resistant gene in a Salmonella typhi-murium strain S129 using the λ RED-mediated recombination method .The constructed mutant asdAΔS129 was validated by culturing in the presence or absence of 2 ,6-diaminopimelic acid (DAP) growth in vitro and evaluating its virulence in BALB/c mice challenge assay .Therefore ,this study has demonstrated that an asdA mutant Salmonella typhimurium has been success-fully constructed .

Acute Disease ; Adolescent ; Coronary Angiography ; Coronary Sinus ; abnormalities ; diagnostic imaging ; Coronary Vessel Anomalies ; complications ; diagnostic imaging ; Electrocardiography ; Female ; Humans ; Myocardial Infarction ; diagnostic imaging ; etiology ; Tomography, X-Ray Computed

Objective To explore 64 row volumetric CT 3D reconstruction in the clinical application of severe craniocerebral injury.Methods 60 patients with craniocerebral injury in our hospital were retrospectively analyzed who accept craniocerebral 64 row volumetric CT 6 to 24 hours after injury. Results All cases got timely diagnosis and treatment, especially for the special parts of brain lesions, ventricle base of skull fractures and pool, and various angles show. Conclusion 64 row volumetric CT reconstruction for the diagnosis of craniocerebral injury shows important significance and may estimate the prognosis in diagnosis, guiding treatment and surgery, reducing misdiagnosis.

OBJECTIVETo evaluate quality of surveillance and emendate rates of birth and death of population of the Three Gorges area.

METHODSData on the two samples collected were designed based on principle of capture-recapture method. An investigation of missing report of birth and death was conducted in 7061 families selected through stratified random sampling method. We collected and registered the data of birth and death in every family investigated and checked with correlative records reported in disease surveillance system of the Three Gorges area. The missing report rates and the 95% confidence intervals of birth rate and death rate were calculated.

RESULTSThe underreporting rates of birth and death were 13.91% and 15.60% and death of infant was 33.33%. The emended birth rate was 8.92 per thousandth and the 95% confidence interval of birth rate was 8.38 per thousandth-9.45 per thousandth. The emended report rate of death was 6.88 per thousandth and the collectivity 95% confidence interval was 6.37%-7.38 per thousandth.

CONCLUSIONResults showed that the quality of birth and death in the disease surveillance reporting system of Three Gorges area was competent to the quality level of the standard set for national disease surveillance system. The birth and death rates of population in the Three Gorges area were under 10.00 per thousandth.

Adolescent ; Adult ; Aged ; Birth Rate ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Humans ; Infant ; Infant Mortality ; Infant, Newborn ; Male ; Middle Aged ; Mortality ; Population Surveillance ; methods

OBJECTIVETo investigate the clinical significance of erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) in the treatment of spinal tuberculosis.

METHODSSixty-seven patients (41 males and 26 females, ranging in age from 23 to 61 years) with active spinal tuberculosis in our hospital (from Mar. 2004 to Mar. 2007) were included in this study. The tuberculosis focus were located either in cervical spine, thoracic spine or in lumbar spine. After 4 to 6 weeks anti-tuberculosis chemotherapy, all the patients underwent one-stage operation (focus debridment) and auto-bone graft combined with internal fixation. Blood test for ESR and CRP were carried out at different times before and after operation.

RESULTSThe average ESR was (79.4 +/- 35.6) mm/h, and the average CRP was (44.3 +/- 17.5) mg/L before chemotherapy, indicating active tuberculosis focus. After 4 to 6 weeks chemotherapy, the average ESR was (45.3 +/- 21.0) mm/h,and the average CRP was (26.7 +/- 11.8) mg/L, the differences were statistically (P < 0.05), and the clinical symptoms of spinal tuberculosis relieved in all patients. Four weeks after operation, the average ESR dropped to (42.8 +/- 16.5)mm/h, the average CRP dropped to (23.8 +/- 10.0) mg/L statistically (P < 0.05). Eight weeks after operation, the average value of ESR and CRP were at normal level in 47 cases, indicating inactive tuberculosis focus. Focus healing was achieved in 65 patients after short-term chemotherapy.

CONCLUSIONThe level of ESR and CRP are high in active spinal tuberculosis and low when focus controlled. ESR and CRP are reliable parameters in evaluation the treatment and prognosis of spinal tuberculosis.

Adult ; Blood Sedimentation ; C-Reactive Protein ; metabolism ; Female ; Humans ; Male ; Middle Aged ; Perioperative Care ; Tuberculosis, Spinal ; blood ; diagnosis ; drug therapy ; surgery ; Young Adult

Objective To investigate the clinical features and neuroimaging features of patients with osmotic demyelination syndrome (ODS).Methods The clinical features and examination results ,including the clinical manifestations,the data of cranial MRI/CT,changes of EEG,treatment and prognosis,were analyzed in 4 patients with ODS.Results All the 4 patients had the history of hyponatraemia.The common clinical manifestations included psychiatric disorder,altered consciousness,dysphasia,dysphagia,quadriplegia and dystonia.Severe transient abnormal EEG was found in these patients,and all the brain CT scanning and CSF were negative.MRI features could only be noted 10 d after the appearing of clinical manifestations and all the first time MRI was negative in these 4 patients.Four patients were diagnosed as having extrapontine myelinolysis,showing symmetrical low T1-weighted signal and high T2-weighted signal within the pons,the basal ganglia,the thalami,the insular cortex and the hippocampal head.Three patients were also diagnosed as having central pontine myelinolysis,showing symmetrical T1 low signal and T2 high signal in the basilar part of pons; much clear imaging could be noted with the help of weighing the abnormal signals.Three patients got improvement with 1 having dystonia sequel.Conclusion ODS is correlated with chronic hyponatraemia,and both hypokalaemia and hypochloremia may be the 2 possible triggers; when they appear,quick correction is not needed.MRI features may be significantly delayed,thus,repeated imaging study is necessary.